Avatar universal


I'm a sixtish male with a history of mitral prolapse/systolic functional murmur, PVCs and PACs. I take very low dose Atenolol. I was told that I have mild acid reflux, but decided to restrict diet rather than take a prescription for that.

I often get what I call "lurches" that seem to be centered in the area of my diaphraghm. These lurches (spasms?) seem to correspond to the old phrase "my heart leaped into my throat." When they were first noticed about 25-30 years ago they were closely correlated with eating spicy food, but were quite infrequent.  Over the years they have varied in frequency of occurence, from a good many days with none, to several a day, to several an hour, to one every few minutes. (Generally, more often as I aged.) About 18 years ago I had them more or less continuously for about 4 hours. A Holter monitor test about that time indicated PVCs and PACs, but no treatment other than the minimum dose Atenolol, and I have never had activity/exercise restrictions.

I have long been convinced that most, if not almost all, of the lurches are STOMACH SPASMS. Doctors have seemed very sceptical of that, insisting they were irregular heart beats. This week I had left arm pain that occurred while having fairly frequent lurches. In the emergency room, bloodwork and EKGs were normal. The doctor (an internist) indicated that the left arm pain might have come from a nerve problem in my neck, and when discussing my "stomach spasms as cause" theory said that the vagus nerve could possibly transfer stomach spasms to the heart.

What is the possibility that my theory is at least somewhat accurate? I would worry a lot less about stomach lurches than if the lurches were from a heart problem!! I have asked several doctors if I could try having my heart monitored aftr eating known "too spicy" foods such as mustard or hot sauce, but got no agreement.

Could the stomach/vagus nerve be a significant source of the lurches? If so, could the lurches  be mistaken for irregular heartbeats? Or, would they almost always/always trigger irregular heartbeats? If the irregular beats are triggered by stomach/vagus, does that mean less cause for anxiety than if they  originate solely in the heart itself? I'd greatly appreciate any information/suggestions/referrals to other info sources, etc. Thanks.  Pete

53 Responses
233190 tn?1278549801
If there is continuing concern that the spasms are coming from the upper digestive tract (i.e. stomach and esophagus), there is testing for that.  

You can consider a 24-hr pH probe with esophageal manometry.  This can evaluate the upper digestive tract, and when any such spasms hit, it will be recorded.  The pH part of the probe will evaluate for GERD.  

This test can be arranged by a GI specialist and can be discussed with him/her.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Avatar universal
Have you tried to take reflux medication to see if the "lurches" subside?

I've often seen patients who are unable to control their acid reflux with diet alone.  Usually starting them on a PPI therapy would subdue any/all symptoms they've seen.

PPI therapy is the most efficacious therapy out right now - because it turns off the activated proton-pumps in the stomach that produce the acid - as well as work on all 3 of the enzymes released during acid production (medication such as Zantac or Pepcid only work on 1).

hope this helps ...

Avatar universal
I posted similar symptoms a couple of weeks ago.  I can actually see the beating in my stomach area.  I had an ekg while in symptoms and it showed an extra beat but blood pressure was good etc..  Are your symptoms relieved or made worse by lying down?  Mine are relieved by getting into a prone position or by exercise such as walking.  I NEVER get symptoms while exercising (Over 60 minutes of cardio) and actually feel excellent for hours/days after.  I was given Prevacid which eventually made my stomach feel "lousy" and then Acifex which did the same.  Did you ever try sipping water, it helps me since sometimes my mouth gets dry during symptoms?  I will look into your supposition...it is interesting since sometimes I will get symptoms by sitting with my left arm on an arm rest above my shoulder or my crouching over a computer with tightness in my upper stomach muscles.  Good luck, I will let you know my research.
Avatar universal
Hey Wally,

Have you ever tried Nexium?
Avatar universal
No, I never tried Nexium.  How would that be different from Prevacid or Acifex?  After writing my last post, I remembered that just before the symptoms really appeared in full force, I suffered a fall on ice inwhich I hit the back of my head pretty hard.  I did not lose consciousness, but the blow was pretty severe.  I was wondering, after doing research on the Vagus nerve, whether that fall could have caused the damage to the nerve.  I appreciate the posts of experience....thanks.
Avatar universal
I disagree totally about the effectiveness of acid reflux meds. The simple fact is you must have stomach acid and enzymes to digest food. Nexium and all the other meds are simply another way for the drug companies to make money. Acid reflux or heartburn as it used to be called can be helped with digestive enzymes and a good probiotic. Your colon must also be moving at least once a day if not more. I suffer from benign pvc's as well and experience the exact same stomach lurches. I was told this is an adrenaline rush(fight or flight response.) This is what makes pvc's so very exhausting. Working on strenthening your adrenals is a good step. Licorice root is good, and there are many combination formulas available in your local herb shop or GNC.
Avatar universal
hey wally,

nexium, from my practice, is a far better agent than both AcipHex or Prevacid -- as it is a derivitive of Prilosec.  From the studies that i've read -- it's a cleaner, longer acting version of Prilosec -- so more patients receive symptom relief faster and better with Nexium than with all others.

if you'd like more comparitive data, i'd check out the american college of gastroenterology website for all of the data on the different medications.  they should have a journal search or something of the sort.  I know that Dr. Donald Castell & Dr. Philip Miner have published a lot of studies on the different PPI therapies, I'd check them out if you'd like more info too.

Nexium is the agent that I prescribe most often -- when -- the awful insurance companies will pay for it.

Avatar universal
I'd do a little more research before totally discounting all of the allopathic medical sciences.  There is a difference between simple heartburn and acid reflux disease (or GERD).  I'd check out the Am. College of Gastroenterology website for a lot of info on the different disease states.
Avatar universal
Acid reflux is not a disease. It is called one so that the pharmaceutical companies can make money off of people who want a quick fix for their health problems. Long term use of your PPi's can cause more problems than it supposedly fixes. I don't dismiss all allopathic medicine, but I have a huge problem with Gerd all of a sudden being a disease. The key is to find out what is causing the reflux and go from there, not masking symptoms.
Avatar universal
astro - you sound like one of those conspiracy theorists that think the big evil drug companies are selling phoney meds to enrich themselves without benefit to their patients.  There is no question that GERD is a disease, and medical science isn't "masking the symptoms".  Physicians routinely search for the cause of reflux disease and treat it. Typically, the cause is a weak or dysfunctional Lower Esophageal Sphincter, which can be treated medically, or as a last resort, surgically. Bowel cleansing, unfortunately, has nothing to do with effective treatment of GERD.

There are numerous web sites connected to reputable teaching hospitals where you can do scholarly research to improve your understanding. I know it isn't the easy way out, but the effort is worthwhile. Please try it. You may want to start with a search of the literature on the Lower Esophageal Sphincter.

Best regards,
Chicken Soup
Avatar universal
Thank you for your comments.  I think I will try Nexium although I have been without any medication for almost three weeks and only have occasional "gerd" (after eating too late at night) which is quickly eliminated by Mylanta liquid.  I only had one "episode" of flutter/spasms which lasted 5-10 minutes and was relatvely minor in strength.  I find most of the "episodes" are preceeded by emotional moments (stress).  I am working on eliminating the stress and eating earlier in the evening.  I think in my case, behavior modification would certainly help.

Thanks again, I appreciate other perspectives.
Avatar universal
Well, I don't think I sound like a conspiracy theorists, but obviously we look at things differently. I don't think anyone can deny that the state of our health in this country and the Western world in general has declined dramatically since the advent of processed and refined foods along with the thousands of prescription drugs that have so many side effects(that are listed on the label) and do damage to the liver. Since immunizations became required, there are thousands of children with autism and other learning disabilities. And the list goes on and on. I know on a personal level about pain and gastrointestinal issues. I was bedridden with them. I tried every prescription drug under the sun trying to get better. I never did until I had a car accident and went to a chiropractor who explained to me how the body works. It was for me a "light bulb" moment. I began to research everything I could get my hands on concerning natural means of healing and lo and behold, it worked. Whether you personally believe in it is of no consequence to me, but if I can touch one persons life and change it for the better, then that's what I will continue to do. If you think the pharmaceutical companies want to cure your disease, then the jokes on you. They have NO interest in curing anything. If they did, then it would have been done by now. We spend too much time studying the sick instead of looking at people who aren't sick and seeing what they do and eat and how they live. Prescription drugs for the most part do mask symptoms. That's why at the end of the commercial for the purple pill, it states that a serious stomach condition may still exist. Doesn't sound too good to me.
Avatar universal
Pete, it was interesting reading about your symptoms as I suffer from exactly the same. I could especially identify with the "heart in my throat". I am a 45 year old male living in UK and I have been suffering from what I thought were palpitations for the past few weeks. My fast heart rate occurs first thing in the morning or after I have eaten (usually in a hurry). I visited my GP yesterday and he explained that it was the vagus nerve and I should not worry. He suggested I take magnesium everyday, so I will start doing this and I will post again in 1 month to let you know how I am getting on.
Avatar universal
After 2 years of utter frustration, I was heartened by the posts I just found from Pete, Wally and Bluebottle.  Those symptom descriptions are the closest I've found to my experience, and I'm desperate for answers.  I have a history of GI problems and was thrown into the IBS "bucket" many years ago, though it never seemed to be a very good match for my symptoms.  My first "lurches", or jolts as I call them, were probably 8 or 9 years ago, but they seemed to be rare and isolated events.  Two years ago I had an acute onset of diarrhea, jolts, tachycardia, dizziness, GI pain, and weakness.  The acute phase lasted 8 weeks, during which I lost 25 pounds (20% of my body weight).  I've had many tests (colonoscopy, endoscopy, 24hr urine for catecholamines, EKG, holter monitor, CT scans, screens for thyroid, glucose, blah blah blah).  While stress certainly doesn't help, I don't believe it
Avatar universal
Elizabeth4, I don't think you're crazy at all!  I went to the emergency room on August 12, 2005 with severe chest pains that radiated through my body back between my shoulder blades.  My arm was also numb.  I thought I was having a heart attack.  I had suffered from reflux for a couple of years, but never thought that there could be a connection.  Well, no heart attack!  It was esophageal and stomach spasms brought on supposedly by acid reflux.  An upper GI series a week later showed only mild reflux (perhaps because I was on a double dose of Aciphex).  My upper endoscopy last week showed "nothing remarkable."  No erosions, no Barrett's Esphagus -- just nothing.  So, here I am with the spasms (even as I write this) and no answers.  My new gastroenterologist took me off the Aciphex and told me to take two Gaviscon tablets followed by 4 oz. of water after every meal and at bedtime.  It seems to be doing a good job of controlling the heartburn. All the Aciphex did was delay food being digested in my stomach.  No stomach acid, no digestion.  So, I feel a million times better in that respect, but I'm still on Donnatol (Belladonna) for the spasms.  Sometimes it works, sometimes not.  Today?  Not.  

Has anyone in this forum been tested for liver problems?  I have not and I'm wondering if I should ask my gastro doc about it.
Avatar universal
Well, a month on and the "heart in my throat" feeling has all but gone away however I still get the sensation 2 or 3 times per day. From what I am reading, I have not been suffering from the same spasms as some of you - it sounds awful. I have been taking 350mg of magnesium everyday (most days) but I really do not know if this has helped or not. I have not changed my diet particularly however I do think that I have been quite stressed recently and that may have been a trigger for the problem. The particular situation that I was worried about(a presentation in front of 50 people) has gone. A coincidence? Maybe I am more relaxed now. Can stress cause refluxing?
Avatar universal
I had the sudden onset of symptoms very much like yours three weeks ago and am having the same experience of tests being normal and no real answers.  I had diarrhea, then racing heart, irregular heartbeat, couldn't catch my breath and then nausea that lasted for nearly two weeks.  Now, the nausea is gone but I have no appetite, never feel hungry.  I've lost 10 pounds and I was only 132 lbs to start.  Did you experience nausea and loss of appetite too during your initial episode too?  You say it lasted 8 weeks, how did it go away?  You also mention that you have recurrent episodes.  Are they as bad as the first one?  How long do they last?  My Dr. says it looks like my stomach is slow to empty, but she can't say what caused it or if it will go away.  The weight loss is very frightening to me, and I can't seem to find anyone else who's had these same symptoms.  Please reply, thank you, and I hope you are feeling well now.
Avatar universal
About two or three weeks ago I started having regular upper stomach lurches,spasms. Now I have pain in left arm. I have been doing some strenuous yard work and house repairs and have been under some stress mentally. I also have change my diet a lot about the same time eating more healthy. I'm 46 very healthy not overweight. This problem came on suddenly. My doctor does not seem to be concerned but gave me famotidine to try for two weeks. I've taken it for three days with no effect but will go on with his presciption. I also had a lot of neck pain, thats gone but the arm pain is still there.

Avatar universal
I have had all the same problems/symptoms as all of you and the same meds nothing has worked. SIX years now and counting! I even have suffered stroke/neurological symptoms from it. But one thing I know that it IS the Vagus Nerve that is causing all of this. My Cousin is a Nurse Practitioner and trys to help me learn. Now the great problem into solveing this is, why do Gastro docs know this and choose to ignore it, ignore us? Vagus Nerve controls alot of things, read up on this please. Vagus nerve causes stomach/intestinal spasums  which in turn throws that fun acid up into the throat and Wah-Lah, GERD! Vegus Nerve controls the heart, epilepsy, it causes malfunctions in the brain and can tell the brain to release adrenalin into your system mimicing STRESS (heart lurches), to name a few......Now what causes the Vagus Nerve to malfunction and cause such pain? It's a "HECKIFIKNOW" thing. I know... one of us needs to go to Med school then come back and cure us all. I have litterly been to over 200 doctors and not one can help. WHY- WHY-WHY-!?! Well as soon as one of you find a doctor that has 100% understanding of our plight, please post it so we all can go and get help. I know there is a new treatment for Epileptics called the "Vagus Nerve Stimulator" which helps to control siezures in epileptics. It is a little box like a pacemaker that turns on and off the Vagus nerve. I wonder if it would help us???? Again any one know a good Doc?   I do agree with the person who said to see a Chiropractor. It does help.  TA-TA!            Val in Cal.

Avatar universal
hello everyone...
at last i feel i have come across people who understand what it is i've been going through...
my ordeal started off with an episode of palpitations two years ago (i am just 28 years old, overweight, sedentary lifestyle with occasional exercise), and it basically changed my life. i became a nervous wreck, waiting for the next episode to happen. Additionally, on and off my heart would 'skip' for no apparent reason, though it would seem to occur more when i am bending or taking in a deep breath (i mean when it happens, not all the time). And then came the 'lurches' which were really bad last year, which i would suffer around 3 times a day. Since then the number of occurrences has reduced a lot, but i still do get them on occasion. I had some heart screening test done 2 year ago (EKG, Stress EKG, Echo sonogram and Holter Monitor -  all the noninvasive tests. Thank God they all turned out negative...
The symptoms toned down a lot within the past year (except for the occasional mild lurches)until i recently experienced palpitations  2 months ago. Since then i feel my health and peace of mind have  gone downhill...i get extra sensitive over any changes in heart patterns, get anxious easily, sometimes feel like there's 'wind' in my stomach right up to my chest... basically lots and lots of symtoms that would suggest something wrong with my heart (especially the palpitations, lurching, and feeling out of breath sometimes).

My questions are:
1) Does anyone think i should have heart screening tests again? (the last one i had was 2 years ago - negative, had AKG done 2 months ago - negative)
2) What should i do?

thanks for listening...
Avatar universal
I have come across this site after looking for help on the web. I have been having extra heart beats for several years. They actually feel like missed heat beats. Recently they have become worse and after one really bad session,when I thought my heart wouldn't start beating again, I saw my consultant and wore a monitor for a week. Needless to say although they did pick up some there were no really bad ones. However for the past few days they have started again and have changed slightly. As well as the missed beats my heart seems to thud and flutter and beats in my throat. Today it it was bad for about 20 mins and although it is doing it now less frequently I feel very uncomfortable. I have read on this site that some people think it is related to reflux and the vagus nerve. Now I have been on Prevacid for 6 years as I do suffer from GERD and have a hiatus hernia and have often thought there was a connection between irregular heart beat and eating, as mine sometimes came on after a heavy meal but am worried that this is not the case with me as my reflux is being treated. Does anyone here being treated for reflux still have the irregular heart beats. I would add that I watch my diet and dont have anything with caffeine in. I am sorry to go on for so long but am sitting here terrified as the feeling of my heart beating irregularly in my throat is so unpleasant. I am a 56 year old female.
Also I have a blood pressure machine and when I am having these episodes I use it as it shows the beating of the heart and I can actually see that it is missing beats. My one worry on this though is that all the family use it and it always works properly, but when I use it when I am having the symptoms it keeps showing errors and won't take a reading. Does anyone know why this is? Thank you.
Avatar universal
spearoelo, the thing that u mentioned with the bp reader is normal..it reads as an error because when ur heart skips the heartbeat becomes irregular and the machine does not know how to calculate it... so it goes into error.

hope this helps
Avatar universal
Thank you.
Avatar universal
After reading your posts I was wondering if any of you have tried Chinese Medicine, or seen an Acupuncturist.
Obviously everyone's body responds differently, but it may really help some of you.
I hope you find some answers, it sounds uncomfortable and disconcerting.
I know someone who suffers from chronic cough with incontinence and was told after all other tests were negative that it must be a vagus nerve problem. Does anyone else experience cough as a symptom?
Is there any way or information about treating a vagus nerve problem?

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